Prosecution Appeals the Acquittal of South African Oncologist Cyril Karabus

April 12, 2013

Although Dr. Cyril Karabus—a highly respected 78-year-old South African pediatric oncologist and professor emeritus of the University of Cape Town—was found innocent of manslaughter charges on March 21, 2013, by a UAE expert medical review committee and the Abu Dhabi Criminal Court, he has been informed by the court that he must remain in the United Arab Emirates indefinitely because the prosecution has decided to appeal his acquittal. At a court hearing on April 9 at which the prosecution was scheduled to present its appeal, the court postponed the proceedings until April 23 on the grounds that a particular medical expert was not present and that a court file was missing. The CHR is deeply concerned that Dr. Karabus is not being treated in accordance with international fair trial standards and that his health is deteriorating as a result of the eight-month judicial ordeal that he has already endured.

In August 2012, while in transit to South Africa from Canada where Dr. Karabus and his family had attended his son’s wedding, he was arrested at Dubai International Airport. It was only after his arrest that he learned he had been charged and convicted in absentia 10 years earlier following a complaint about his treatment of a young leukemia patient who died while he was working as a locum at a medical centre in Abu Dhabi. Despite his age and poor health—he has a pacemaker, suffers from coronary heart disease, and had to be moved to the medical wing of the prison during his detention—Dr. Karabus was jailed for two months. After four unsuccessful requests for release pending trial, the court finally ordered his release on October 2012 after his family paid a substantial bail. Although his original conviction was set aside by the court because he had been deprived of the right to defend himself, the court judge ordered that he be retried.

In 2002, Dr. Karabus worked for Interhealth Canada (a global health management firm) for approximately five weeks at the Sheikh Khalifa Medical Centre in the UAE as a locum, temporarily replacing Dr. Lourens de Jager. During that time, Dr. Karabus treated a three-year-old Yemeni girl who suffered from acute myelocytic leukemia. She was already undergoing chemotherapy when he took over her care. The treatment recommended to the patient’s parents was a bone marrow transplant, which they refused. Dr. Karabus reportedly then ordered a platelet transfusion, which was carried out and documented in her medical file. The patient’s health deteriorated rapidly, and she died while Dr. Karabus was still working at the Medical Centre. Two weeks after the patient’s death, Dr. Karabus’s locum work was concluded, and he returned to South Africa. Sometime later the girl’s family issued a complaint about her treatment. Without ever notifying Dr. Karabus, he subsequently was charged with manslaughter and falsifying documents. The prosecution reportedly alleged that Dr. Karabus failed to order a platelet transfusion, the procedure that would have been the appropriate treatment for the child. The prosecution further claimed that his failure to do so, not her cancer, was the cause of her death. It was also alleged that he falsified a document stating that he had ordered the transfusion. He was convicted in absentia on both charges, sentenced to three and a half years in prison, and ordered to pay “blood money” (diyyah) in an amount to be determined by the family of the patient. Dr. Karabus was neither notified of the charges and the trial nor of the conviction and sentence and thus never had an opportunity to defend himself in court.

Since his arrest Dr. Karabus has had to attend court hearings more than a dozen times and endure numerous delays because of the prosecution’s failure for many months to produce the patient’s original medical file, as ordered by the court. (Without the complete, original medical file, the prosecution had no evidence to support the charges brought against Dr. Karabus; and, in turn, the defense could not prove his innocence.) A copy of the medical file was eventually produced by the prosecution, which Dr. Karabus and his lawyers said provided ample evidence that he did not commit any crime. An expert medical panel appointed by the court to review the case finally met on March 19, 2013, and examined the file, after which it absolved Dr. Karabus of any wrongdoing. It reported its findings to the judge, and two days later Dr. Karabus was found not guilty.

Dr. Karabus is a pediatrician and an internationally respected expert in the fields of pediatric oncology and hematology. At the Red Cross Children’s Hospital in Cape Town, he pioneered treatment for cancer and blood disorders and has received public tribute for the dramatic reduction in the mortality rate of children with leukemia from 80% to 20% during his tenure as head of oncology at the Red Cross Hospital. During the apartheid era, Dr. Karabus reportedly devoted himself to providing cancer treatment to black children in some of the country’s most disadvantaged areas. He is also professor emeritus of University of Cape Town’s Department of Pediatrics and Child Health.

The CHR and other members of the National Academy of Sciences, National Academy of Engineering, and the Institute of Medicine, as well as national science academies abroad that are members of the CHR’s international human rights network, have sent repeated appeals to the UAE government in Dr. Karabus’s behalf. Academies’ members have also written notes to Dr. Karabus to let him know that his international scientific colleagues are aware of his plight and are taking actions to help resolve his case. Dr. Karabus’s plight has been of great concern to the international medical community. According to his family, with whom the CHR has been in frequent contact, numerous health professionals have written to the UAE court testifying to his medical expertise and integrity. Most recently the World Medical Association (WMA) issued a resolution expressing its concern that Dr. Karabus is being forced to remain in the UAE indefinitely despite being found innocent by an expert medical panel and the court. The WMA also is publishing “an advisory notice to advise doctors thinking of working in the UAE to note the working conditions and the legal risks of employment there.” It is encouraging member national medical associations to do the same. The South African Medical Association also has expressed its concern and has cautioned other South African medical doctors about the risks of working in the UAE.